Improving Child Health in Recovering South

South Sudan

August 31, 2006

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    Mercy Corps uses a "positive deviance" model that spotlights women with healthy kids and gives them a stage to demonstrate to peers how to properly feed a child. Photo: Mercy Corps Sudan

Few habitable places on earth are more remote than the villages of Ulang County, South Sudan. Some families there live a two-hour walk from the nearest water source. Others can reach the main town only by walking six hours along a narrow trail. These villages are so inaccessible by road that international aid of maize, sugar and milk is delivered not by truck, but by airplane.

Despite these ongoing food distributions, many of the area's children are malnourished and fall sick easily. It's just one nasty legacy of this country's long-running civil war, which displaced thousands of people and disrupted age-old livelihoods and trading practices.

Mercy Corps is responding to the needs in Ulang County with a community nutrition program that relies on the existing knowledge of village mothers. Rather than assume a traditional teaching role, Mercy Corps uses a "positive deviance" model that spotlights women with healthy kids and gives them a stage to demonstrate to peers how to prepare food hygienically and how to properly feed a child.

Relief workers, in their research into the region's malnutrition problem, found that some parents unrealistically expected small children to feed themselves. As a result, these children were underfed. What's more, unsanitary cooking conditions were increasing the likelihood of contaminated food and disease.

Mercy Corps worked with a local partner, the African Centre for Human Advocacy, to arrange meetings of village mothers to discuss how they feed their children. Mercy Corps' Michael Muki Gordon explains that the format of these gatherings allow villagers to recognize the most effective techniques used by mothers without singling out the best or worst.

"You can't tell these mothers who does things well and who does things poorly. So we let everyone tell the story about how they feed their child," says Gordon. "Then we ask them, What can we learn from these stories?"

Lessons about kitchen sanitation are transmitted in similarly informal settings. For 12 straight days, about a dozen local mothers gather in a nearby home for two-hour "Hearth" sessions. There, a trained educator facilitates a hands-on learning session. In the midst of cooking, cleaning and talking, the women discuss the importance of keeping the kitchen clean, covering food to protect it from flies and having a washbasin nearby. Educators also demonstrate what sorts of foods are most appropriate for children.

"We want to tap the local knowledge, and use that knowledge to educate others," explains Gordon.

Supervisors and volunteers, who are selected from the target villages, follow up with mealtime visits to make sure good hygiene practices are being followed. In the three villages where the program has been initiated, Gordon says there's a visible difference in child health.

Improving household nutrition over the long term will require villagers, many of whom lost their herds in armed skirmishes - and along with them, their traditional pastoralist lifestyle - to improve their crop yields. Mercy Corps has helped the African Centre for Human Advocacy establish a demonstration garden with new crops such as eggplant, cabbage and carrots. They're also helping farmers get the most from their land.

"Our aim," explains Gordon, "is that when we leave, they can carry on these projects."